WaSH as a maternal health issue: three perspectives from rural Uganda

ABSTRACT

Inadequate water, sanitation, and hygiene (WaSH) knowledge and practices affect maternal and newborn morbidity and mortality. This article describes postpartum knowledge, resources, and practices in three rural Ugandan hospitals. A lack of WaSH resources was problematic for both staff and newly-birthed mothers who demonstrated a lack of knowledge about the appropriate use of WaSH resources and the links between WaSH and health protection. These results suggest that in addition to increasing the availability of medical interventions, basic preventative public health practices should be reflected in policy and practice integrated across the spaces inhabited by pregnant women to achieve improved maternal and newborn outcomes.

KEYWORDS:

• Social sector – Water and sanitation, Health
• Sub-Saharan Africa

Acknowledgements

This paper is an outcome of a joint initiative between McMaster University, Uganda Christian University, and the United Nations University Institute for Water, Environment, and Health, with special thanks to the staff and students of the Master of Public Health (Leadership), Save the Mothers Programme and the Mother Baby Friendly Hospital Initiative. Data collection was supported by funds from UNU INWEH.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Corinne Schuster-Wallace is a water-health expert with the Global Water Futures Program at the University of Saskatchewan. She has broad experience at the water-health nexus including environmental factors, climate change impacts, WaSH and linkages to human health and well-being.

Susan Watt is Professor Emerita, School of Social Work, McMaster University and Adjunct Professor, UNU-INWEH. Her work examines maternal and newborn health in Canada and abroad. Her most recent research focuses on improving maternal and newborn outcomes by sustainably improving WaSH conditions in health facilities and their communities.

At the time of the research, Zachariah Mulawa was the Deputy Academic Coordinator, Save the Mothers Programme, Uganda Christian University, Mukono, Uganda.

At the time of the research, Morgan Pommells was a Graduate Student in Social Work at McMaster University and enrolled in the Water Without Borders Certificate programme. She is currently posted to Bangladesh as an Aga Khan Fellow.

Notes

1. The MBFH initiative is an elaboration of the WHO Baby Friendly Hospital, which is currently being implemented in nine pilot hospitals throughout Uganda. It uses a ten-component framework designed to enhance the capacity of health facilities to provide patient-centered yet systematic care based on best evidence and practices. See www.savethemothers.org/what-we-do/mother-baby-friendly-hospital-initiative.

2. The WHO Hand Hygiene Knowledge Questionnaire captures information regarding germs, exposure, and handwashing practices and procedures. Since data collection for this article, WHO has developed a “Cleans” framework that represents six “cleans” that also include clean hands (practices and procedures) and clean surfaces (exposure) (Gon et al. 2017).

Additional information

Funding

This work was supported by United Nations University Institute for Water, Environment, and Health, Hamilton, Canada.